Risk Factors and Prevention of Prostate Cancer

Author: Anum Shabbir, RPh (Community), MW, IMC

Reviewed by Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Introduction

Prostate cancer is a disease in which cancer cells develop in the prostate (a gland in the male reproductive system). In the US, prostate cancer is the second most common cancer to affect males. All men are at risk of developing prostate cancer. Approximately 13 out of every 100 American men will develop prostate cancer over their lives, and 2 to 3 men will die from it.

Risk factors associated with Prostate cancer

A risk factor is something that increases the chances of developing a condition, such as a disease. Different diseases have varying risk factors. While certain risk factors, like smoking, can be modified, others, such as age or familial history, cannot. [1]Prostate cancer is commonly associated with the following risk factors: [2]

• Advanced Age
• Ethnicity
• Genetics
• Family History 
• Diet High In Saturated Animal Fat And Red Meat 
• Obesity
• Physical Inactivity
• High blood sugar level

1. Advanced Age 

Older men are more likely to be diagnosed with high-risk prostate cancer and have shorter overall survival rates. White men with no family history of the disease had a significantly higher risk after 50, while Black men have a higher risk after 40. 

2. Ethnicity, Genetics and Family History 

The prevalence of prostate cancer varies significantly by race. The highest incidence rate is observed among African-American men. African Americans may not receive high-quality healthcare, leading to lower rates of PSA (prostate-specific antigen) screening. Black men, both with and without prostate cancer, had considerably higher PSA screening levels compared to white men. Approximately 20% of prostate cancer patients have a family history, which could be due to inherited genes, exposure to environmental cancer-causing substances, or lifestyle choices.

3. Obesity and Diet High In Saturated Animal Fat And Red Meat 

Men who eat five or more servings of processed meat each week are more likely to get prostate cancer than men who eat one or fewer dishes. Saturated animal fat intake increases the chances of prostate cancer by producing free radicals, which cause cell damage. Obese men produce higher levels of hormones, which are known to play a role in prostate growth and turn normal cells into cancer cells.

4. Physical inactivity and high blood sugar 

Impaired action of glucose-lowering hormone  and  decreased sugar absorption are caused by physical inactivity. This leads to persistently high  levels of sugar-controlling hormone (insulin) in the blood. Insulin is a hormone that stimulates growth and multiplies cells rapidly. High blood sugar level is associated with an increased risk of prostate cancer among men .

Can prostate cancer be prevented?

The following is a set of flexible practices that help prevent cancers, including prostate cancer, through adopting lifestyle changes [3] 

• Eat a diet high in cereals, vegetables, fruits, and beans. Aim for at least 30 grams of fiber every day.
• Maintain a healthy weight range (body mass index, BMI, 18.5-24.9) throughout life. Maintaining a healthy body weight is crucial to avoid long-term weight gain. 
• Limit intake of "fast foods" and processed foods rich in fat or sugar. Reducing these foods can help maintain a healthy weight. 
• Consume red meat, such as beef, pork, and lamb, in small amounts. Avoid eating red meat more than three times a week.
• Maintain moderate physical activity such as walking, cycling, running, swimming, and sports, and follow national guidelines.
• Reduce your consumption of sugary drinks. Drink mainly water and unsweetened drinks. Drinking sugar-free liquids or tea can help you stay hydrated. 

Screening recommendations

Patient survival rates can be improved by early detection of prostate cancer. Cancer patients have worse survival rates in developing countries due to delayed diagnosis and inadequate treatment resources. [4]For prostate cancer, there is no single, specific test; however, the following are some of the screening tests used to identify changes in the prostate gland. [5]

Digital Rectal Examination (DRE)

Prostate cancer cannot be identified with a single test, although it is commonly diagnosed with a digital rectal examination (DRE). This involves inserting a gloved finger into the patient's rectum to measure the size of the prostate gland and detect abnormalities. 

Prostate-specific antigen (PSA) test

• The test remains the primary screening tool for prostate cancer.
• It is a glycoprotein produced by cells in the prostate gland. It is often found in sperm but can also be detected in the bloodstream. 
• The testing involves taking blood samples to determine the amount of PSA. The  readings above 4 ng/mL indicate that the patient needs additional testing.
•  If the PSA is greater than 10 ng/mL, the chances of having prostate cancer are more than 50%. 

Prostate tissue biopsy

• Biopsy is one of the most reliable methods for the diagnosis of prostate cancer 
• A medical technique that uses a thin, hollow needle to obtain small tissue samples from the prostate gland for microscopic examination. This test can be conducted through the skin of the opening where stool comes out and the lining inside it.

Magnetic Resonance Imaging (MRI)

• This can be used as an adjunct to the diagnostic methods.

Myths vs. Facts

Many people have misconceptions regarding the risk factors for prostate cancer, despite how common it is. Although a lot of advancements have been made in treatment strategies, there are still a lot of myths about prostate cancer. (6)

Myth 1: Prostate cancer can affect old men only

Although the majority of people affected by prostate cancer are elderly, it can also affect younger men. About 40 percent of prostate cancer occurs in men younger than 65. 

Myth 2: If there are no symptoms, prostate cancer does not exist

At the early stages of prostate cancer, it does not show any kind of symptoms, whereas at later or advanced stages, the symptoms start appearing.

Myth 3: Enlarged prostate gland  is linked with Prostate cancer

Prostate cancer and benign prostatic hyperplasia are different from each other. Benign prostatic hyperplasia is a type of non-cancerous growth. So the size of the gland is not directly linked with the development of cancer in the prostate.

Myth 4: Prostate cancer is not risky and does not need treatment

In low-income countries, almost 50% of prostate cancer cases are detected in advanced stages, after the illness has spread beyond the prostate gland.  Delayed diagnosis can lead to organ damage and death. 

Conclusion

Prostate cancer is the second most common cancer among males. Prostate cancer risk factors include advanced age, family history, lifestyle, and diet. Screening methods allow for early detection of problems, leading to effective management and improved quality of life. By promoting smoking cessation, regular exercise, and maintaining a healthy weight. Lifestyle changes can reduce the chance of getting cancer and improve survival rates for prostate cancer patients. Screening methods allow for early detection of problems, leading to improved quality of life and effective management. Always consult a doctor for expert advice and diagnosis of a condition.

References:

1.     Habib A, Jaffar G, Khalid MS, Hussain Z, Zainab SW, Ashraf Z, et al. Risk factors associated with prostate cancer: prostate cancer. J Drug Deliv Ther [Internet]. 2021 Mar 15 [cited 2025 Mar 14];11(2):188–93. Available from: https://jddtonline.info/index.php/jddt/article/view/4758

2.     Rawla P. Epidemiology of prostate cancer. World J Oncol [Internet]. 2019 Apr;10(2):63–89. Available from: https://pubmed.ncbi.nlm.nih.gov/31068988/

3.     Marino P, Mininni M, Deiana G, Marino G, Divella R, Bochicchio I, et al. Healthy lifestyle and cancer risk: modifiable risk factors to prevent cancer. Nutrients [Internet]. 2024 Mar 11 [cited 2025 Mar 14];16(6):800. Available from: https://www.mdpi.com/2072-6643/16/6/800

4.     Bashir MN. Epidemiology of prostate cancer. Asian Pac J Cancer Prev [Internet]. 2015 [cited 2025 Mar 14];16(13):5137–41. Available from: https://journal.waocp.org/article_31224_cb5c5794cab07d9e829f4f5330474e96.pdf

5.     Sekhoacha M, Riet K, Motloung P, Gumenku L, Adegoke A, Mashele S. Prostate cancer review: genetics, diagnosis, treatment options, and alternative approaches. Molecules [Internet]. 2022 Sep 5 [cited 2025 Mar 14];27(17):5730. Available from: https://www.mdpi.com/1420-3049/27/17/5730

6.     Aderibigbe O. prevalence, myth, prevention and management of prostate cancer.Liaoning Technical University - Natural Science Journal. [Internet]. 2024 [cited 2025 Mar 14]. Available from: https://lgjdxcn.asia/admin/pdf_files/V184004-2024.pdf

Published April 16, 2025